A Case of Recurrent Psoriasis: Evaluation & Treatment of a 33-Year-Old Male | Village Dermatology Katy & Houston, TX
At Village Dermatology in Katy and Houston, Texas, we frequently see patients who have been treating a rash unsuccessfully on their own or with medications prescribed for a different condition. Psoriasis is one such condition that can mimic other rashes early on, making professional evaluation critical.
This case features a 33-year-old male who presented with a spreading rash across his trunk. After a detailed review of history, appearance, and prior treatments, his condition was diagnosed as psoriasis, a chronic inflammatory skin disease.
Patient Overview
Chief Complaint
A pink and red rash on the trunk, moderate in severity, present for 3 weeks.
History
Initially began on the right lower leg, then spread to the body
Previously treated 6 months earlier with ketoconazole 2% cream for presumed ringworm
Ketoconazole helped initially but no longer provides improvement
No nail pitting or ridging
No joint aches or stiffness (important in ruling out psoriatic arthritis)
Exam Findings
Clinical evaluation revealed:
Psoriasiform plaques
Micaceous (silvery) scale
Distribution across the trunk and extremities
No signs of tinea (fungal infection)
No nail involvement
These findings were strongly consistent with plaque psoriasis.
Diagnosis: Psoriasis
Psoriasis is a chronic autoimmune condition characterized by:
Red or salmon-colored plaques
Thick, overlying scale
Recurrent flares and remissions
Symptoms often worsen due to:
Stress
Infections (especially strep throat)
Some medications
Alcohol
Cold, dry weather
Treatment Plan
After an in-depth conversation outlining treatment options, the patient elected to begin topical therapy, which is appropriate for mild to moderate psoriasis without joint involvement.
1. Calcipotriene 0.005% Cream
A vitamin D analog
Apply twice daily on weekends
Helps regulate skin cell turnover
Reduces plaque thickness and scaling
2. Triamcinolone 0.1% Cream
A medium-strength topical steroid
Use twice daily on weekdays for 2 weeks, then as needed for flares
Reduces redness, itching, and inflammation
This “weekday steroid + weekend calcipotriene” rotation helps improve psoriasis while minimizing steroid overuse.
Counseling & Supportive Care
Patients were advised to incorporate:
Emollients (thick moisturizers) daily
Ambient sunlight exposure (brief, gentle exposure—not sunburn)
Medicated shampoos containing tar, selenium, ketoconazole, or zinc pyrithione for scalp symptoms
Avoid known triggers when possible
Long-Term Expectations
Psoriasis is a lifelong condition, with periods of remission and flare-ups.
Treatment aims to reduce symptoms, slow flare frequency, and improve quality of life.
Follow-Up
A 3-month follow-up was scheduled to reassess progress and adjust therapy as needed.
Dermatology Expertise in Katy & Houston, Texas
Whether your rash is new, persistent, or worsening, a board-certified dermatologist can help determine the right diagnosis and treatment plan. At Village Dermatology, we provide advanced care for psoriasis—from topical therapy to phototherapy to biologics like Skyrizi when appropriate.
We’re committed to helping you achieve long-term skin relief.
